摘要
目的分析连续性肾脏替代疗法(CRRT)治疗脓毒症合并急性肾损伤(AKI)患者的疗效及对尿液肾损伤分子-1(kidney injury molecule-1,KIM-1)水平的影响,为合理制定感染性AKI的临床治疗方案提供客观依据。方法选取2015年11月-2018年3月医院收治的96例脓毒症合并AKI患者作为研究对象,按治疗方案分为研究组41例和对照组55例。研究组接受CRRT治疗,对照组为常规治疗。观察两组患者尿量恢复时间、器官支持时间、ICU治疗时间、心血管事件发生率,比较患者治疗前、治疗第7天血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、肌酐(SCr)和尿液KIM-1水平的变化。结果研究组患者尿量恢复时间、器官支持时间、ICU治疗时间较对照组均缩短(P<0.05),心血管事件发生率较对照组降低(P<0.05);治疗第7天,两组患者血清hs-CRP、TNF-α、SCr水平和尿液KIM-1水平均下降,但研究组患者指标水平低于对照组(P<0.05)。结论在脓毒症合并AKI的治疗中,应用CRRT治疗能够提高治疗效果、促进肾功能恢复、降低心血管事件发生率和尿KIM-1水平、减轻患者的炎症反应程度,有利于改善患者的预后,具有较好的应用效果。
OBJECTIVE To observe the effect of continuous renal replacement therapy(CRRT)on treatment of the sepsis patients complicated with acute kidney injury(AKI)and the influence on kidney injury molecule-1(KIM-1)so as to provide objective basis for development of reasonable clinical treatment programs.METHODS A total of 96 sepsis patients complicated with AKI who were treated in the hospital from Nov 2015 to Mar 2018 were recruited as the study objects and divided into the study group with 41 cases and the control group with 55 cases according to the treatment programs.The control group was treated with CRRT,while the control group was given conventional therapy.The time of recovery of urine volume,time of organ support,time of treatment in ICU and incidence of cardiovascular events were observed,and the levels of serum high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),creatinine(Cr)and urine KIM-1 were compared before the treatment and at day 7 of treatment.RESULTS The time of recovery of urine volume,time of organ support and time of treatment in ICU were significantly shorter in the study group than in the control group(P<0.05).The incidence of cardiovascular events of the study group was significantly lower than that of the control group(P<0.05).The levels of serum hs-CRP,TNF-α,Cr and urine KIM-1 of the two groups of patients were reduced on Day 7 of treatment,however,the levels of above indexes of the study group were significantly lower than those of the control group(P<0.05).CONCLUSION CRRT may improve the effect on treatment of the sepsis patients complicated with AKI,facilitate the recovery of renal function,reduce the incidence of cardiovascular events and urine KIM-1 level,alleviate the inflammatory response and improve the prognosis of the patients.
作者
夏艳梅
石海鹏
武卫东
王秀哲
杨晓静
XIA Yan-mei;SHI Hai-peng;WU Wei-dong;WANG Xiu-zhe;YANG Xiao-jing(Shanxi Dayi Hospital of Shanxi Academy of Medical Sciences,Taiyuan,Shanxi 030032,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第17期2594-2597,2610,共5页
Chinese Journal of Nosocomiology
基金
山西省卫生厅科技攻关基金资助项目(2012-01050)
山西省科技厅基金资助项目(20150313011-1)
关键词
连续性肾脏替代疗法
脓毒症
急性肾损伤
肾损伤分子-1
疗效观察
Continuous renal replacement therapy
Sepsis
Acute kidney injury
Kidney injury molecule-1
Observation of therapeutic effect
作者简介
通信作者:武卫东,E-mail:13503545010@163.com
